Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at The Surgery, Pelton on 5 July 2016. Overall the practice is rated as good.

Our key findings across all the areas we inspected were as follows:

• There was an open and transparent approach to safety and an effective system in place for reporting and recording significant events.
• Risks to patients were assessed and well managed, however we found that prescription pads were recorded but their usage was not monitored in line with national guidance. The practice was informed of this on the day of inspection and they agreed to implement a monitoring form in line with national guidance.
• Staff assessed patients’ needs and delivered care in line with current evidence based guidance. Staff had been trained to provide them with the skills, knowledge and experience to deliver effective care and treatment.
• Patients said they were treated with compassion, dignity and respect and they were involved in their care and decisions about their treatment.
• Information about services and how to complain was available and easy to understand. Improvements were made to the quality of care as a result of complaints and concerns.
• Patients on the day said they mainly found it easy to make an appointment with a named GP and there was continuity of care, with urgent appointments available the same day.
• The practice had struggled to recruit a GP and Nurse Practitioner following staff leaving and had seen a negative impact on appointment availability because of this. However they had made every attempt to mitigate the effect of this on patients and staff. Measures included training staff in multiple roles to enable cover and the recruitment of a pharmacist to see patients who needed medication reviews in order to reduce the pressure on GP appointments. They had also recently managed to recruit both a newly qualified GP and a Nurse Practitioner who were due to start soon.

• The practice offered a Weekend Support for Vulnerable Patients scheme in conjunction with the Clinical Commissioning Group. Patients identified as potentially needing contact over the weekend were informed of the scheme and telephone contacts or visits were arranged.

• The practice had good facilities and was well equipped to treat patients and meet their needs.
• There was a very clear leadership structure and staff felt well supported by management. The practice proactively sought feedback from staff and patients, which it acted on.
• The provider was aware of and complied with the requirements of the duty of candour.

We saw areas of outstanding practice:

The practice had a GP who had undertaken training in ophthalmology and the practice had invested in specific equipment to enable detailed eye examinations. This helped reduce attendance at Accident and Emergency departments.

The practice proactively reviewed governance and performance management arrangements in order to address staff shortages. Leadership at the practice motivated staff and drove continuous improvement and all staff were accountable for delivering change. The practice displayed a strong sense of valuing its staff and proactively looked at ways in which to retain them.

The areas where the provider should make improvement are:

The practice should monitor the new process of recording the usage of prescription pads via monitoring forms in line with national guidance to ensure it becomes embedded in practice.

Professor Steve Field (CBE FRCP FFPH FRCGP) 

Chief Inspector of General Practice

People were positive about the care they received at the practice. Comments included, “I am happy with the service here” and “The doctors are very good”.

We found people were given all the information they needed to make an informed decision about their care.

We saw people were cared for effectively and care was planned for the individual.

We saw people were safe and protected from abuse.

People were protected from the risk of infection as the provider had a robust system in place to ensure their safety.

We saw there was an effective recruitment system in place.